| Alliance Psychiatric Group Inc A Medical Corporation | |
|
2082 Business Center Dr Ste 255 Irvine CA 92612-1162 | |
| (714) 769-6090 | |
| Not Available |
| Full Name | Alliance Psychiatric Group Inc A Medical Corporation |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2082 Business Center Dr Ste 255, Irvine, California |
| Authorized Official Name and Position | Moses Morar (PARTNER) |
| Authorized Official Contact | 9495743341 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alliance Psychiatric Group Inc A Medical Corporation Po Box 6040 Irvine CA 92616-6040 Ph: (714) 769-6090 | Alliance Psychiatric Group Inc A Medical Corporation 2082 Business Center Dr Ste 255 Irvine CA 92612-1162 Ph: (714) 769-6090 |
| NPI Number | 1386146496 |
|---|---|
| Provider Enumeration Date | 03/05/2018 |
| Last Update Date | 07/17/2024 |
| Certification Date | 07/17/2024 |
| Medicare PECOS PAC ID | 1254675812 |
|---|---|
| Medicare Enrollment ID | O20181207002274 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386146496 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 95003733 (California) | Secondary |
| Provider Name | Farhad G Nikoo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740485101 PECOS PAC ID: 9133214083 Enrollment ID: I20090223000335 |
| Provider Name | Mike Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003206004 PECOS PAC ID: 7618297532 Enrollment ID: I20150518000183 |
| Provider Name | Moses Morar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134586670 PECOS PAC ID: 2466735253 Enrollment ID: I20170201000858 |
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